Keith Humphreys thinks that making pseudoephedrine a prescription-only medicine could shrink the supply of methamphetamine and reduce the damage done by methamphetamine production and abuse. Megan McArdle doubts that the benefits would last, and points to the high costs in money and unrelieved symptoms of making pseudoephedrine harder for genuine patients to get. She even objects to the current policy that puts pseudoephedrine “behind the counter.”
Having not looked closely at this case, I’m not sure whether Keith’s preference for regulation or Megan’s aversion to it provides better policy guidance in this case, though the history of supply control efforts is anything but encouraging.
But Megan makes a common conceptual mistake when she heads her post “The Cost of Meth Prohibition.” The cost she’s concerned with is the cost of a specific enforcement initiative. If we put Sudafed back on the pharmacy shelf, methamphetamine would still be prohibited. Compared to legal commerce, that alone greatly reduces the availability of the drug. So the case for less vigorous regulatory efforts to enforce prohibition isn’t the same as the case against prohibition itself.
In the case of meth, it’s not just the drug that’s noxious; so is the production process. And it’s true that prohibition faces us with a choice between tighter restrictions and more lab activity (assuming that the restrictions would be effective nationally in the long run, as they have been at the state level in the shorter run). So there’s a possible argument - though not, in my view, a convincing one - that the costs of increased meth abuse due to legalization would be preferable to the costs of either more lab activity due to loosened restrictions or the losses to patients due to tighter restrictions. (Keith’s claim that there would be clandestine production even if the drug were legal seems hard to sustain; meth as a legal drug would cost next to nothing to make.)
But we can’t have a sensible debate about the tactics of drug control if every tactical issue gets linked to the prohibition/legalization argument. They’re simply not the same thing.
“Megan McArdle doubts that the benefits would last”
Mark, did you mean to link to another post at this blog, rather than, say, this?
Anyway, if your point is that meth lab fires are yet another cost of prohibition, and that McArdle should have made this explicit, (I thought she did imply it.) you’re quite right, and kudos to you for admitting it.
Thanks for posting Mark, this debate got off track. The first time I heard about controlling sudafed was from a reform activist who said it was the best form of harm reduction around.
As for my claim that there would still be labs under legalization, this is not inconsistent with the reality that making meth legally would be incredibly cheap. I am assuming some regulation, e.g., taxes and hours of sale. If someone wants to defend the proposition that meth should be legalized and sold as a cheaply as chewing gum at all hours of the day, let them do so…I am clinically trained, after all.
I’d assume that as happens for alcohol, the legally-available meth would be re-sold illegally; there is still a bit of bootleg distilling, but most bootlegging is illegal sales of legal alcohol. (And I’d advocate for setting tax/regulation levels on any of the legal psychotropes, including and most relevantly the narcotics, so only the last link in the chain is illegal, just on harm-reduction grounds.)
The whole “sell the sudafed behind the counter” initiative is a bit akin to having to report cash transactions over 10k. The idea is to constrain the volumes purchased in a single transaction. Someone determined to get some quantity of the psuedoephedrine experiences some inconvenience, but all one has to do is have multiple buyers or multiple stores and the problem is solved.
I do believe that meth is one of the more interesting debates over legalization, as there’s a case to be made that the supply side hazard (potentially quite significant) is an offset to the user damages. Where’s the balance? Who knows. I’m sure someone perhaps has some actual data on actual numbers of illegal meth labs, based on actual discoveries. In watching the media coverage, it seems to peak after some number of raids, with the LE folks in hazmat suits. Then it seems to fall off.
If I have to guess, meth is also a drug whose use and prevalence tracks poverty reasonably well.
Putting Sudafed behind the counter constricts supply for people who would use it in two ways: by making it more expensive and by making it more invconvenient to obtain. Making it prescription-only not only raises the cost of a box of cold medicine by the $100 doctor’s visit it takes to get a script, but also renders it essentially unavailable for casual use with the added inconvenience of scheduling the visit and filling the prescription. In the previous thread, I asked proponents to try to quantify the cost to society of making Sudafed essentially unavailable for cold sufferers. If I find time later I might do it myself, but I have to rush off to work.
I was interested in Rob’s PSE import datum. Where did the extra three hundred metric tons go?
People use pseudoephedrine to fight allergies too, not just colds. On the days when I need it, I feel like a zombie without it.
Another problem with putting pseudoephedrine behind the counter is that it has severely restricted the types I can buy, since space in the pharmacy is much more limited than space on the public shelves. I used to use the Target house brand of Sudafed Non-Drying. It does a better job of unclogging my nose than the regular Sudafed, and reduces the discomfort of drying. Now, it’s not available; Target discontinued it when the restrictions went in place. I can get the non-drying formula without pseudoephedrine, but that’s mostly ineffective as a decongestant for me. Instead, I put up with the downside of the regular Sudafed.
Unless this has made a serious dent in meth production, I resent being told to use an inferior product.
Rick:
The difference is nobody’s health and inalienable right to treat their illnesses suffer as a result of the $10,000 requirement.
The fact that this screws over the HEALTH of an innocent group of people makes it not simply a matter of weighing costs and benefits.
Just in case there are any pharmacists reading this, sometimes when I take the 12-hour Sudafed for my allergies, at about the end of the 12 hours, I get this amazing, happy and calm feeling. It’s really wonderful. If someone could figure out what that is, I’d buy it. I assume that this is *not* what meth is like, but I suppose it could be related. But there’s no hyperness at all. It lasts maybe a half hour at most. It doesn’t seem to happen anymore though, maybe because I take the generic? But it never happened every time. Anyhoo. It was really great. And I know I didn’t imagine it.
Now you’ve done it! The drug warriors will want to ban it completely.
Not if we sneak it into their milk!
Though of course, I am against that.
On the other hand, from what I read, all that cr*p is in the water already. Go EPA!!!